Group A Streptococcal Septic Hip Arthritis in a Child With Spastic Triplegic Cerebral Palsy

We evaluated the outcome of a community-based early intervention and habilitation for children with cerebral palsy (CP) in Bangladesh. Children registered on the Bangladesh CP Register (BCPR) were recruited in two groups for this study: Group A received a comprehensive six-month long community-based caregiver-led intervention program at the “Shishu Shorgo” (Bengali title, which translates to ‘Children’s Heaven’) Early Intervention and Rehabilitation Centres developed to support participants from the BCPR. Group B received standard care. A quasi-experimental study was conducted. Data were obtained at baseline, at the end of the program (i.e., 6 months), and at a 12-month follow-up. Outcome measures for children included gross motor functional measure (GMFM-66), Communication Function Classification System (CFCS), and Viking Speech Scale (VSS) and, for adult caregivers, the depression, anxiety, and stress scale (DASS 21). Between October 2016 and March 2017, 156 children with CP were recruited (77 in Group A and 79 in Group B). The total score of GMFM-66, CFCS level, and VSS level significantly improved statistically in Group A (p < 0.05 for all) and deteriorated in Group B (p < 0.001, p = 0.095, p = 0.232). The intervention showed promising outcomes particularly for children with CP under five years of age. There is a need for caregiver-led community-based programs for children with CP in LMICs.

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COMPARATIVE STUDY OF EFFICACY OF CRYOTHERAPY AND MYOFASCIAL RELEASE TECHNIQUE IN CALF MUSCLE SPASTICITY IN SPASTIC DIPLEGIC CEREBRAL PALSY CHILDREN

Journal of medical pharmaceutical and allied sciences ◽

10.22270/jmpas.v10i4.1274 ◽

2021 ◽

Vol 10 (4) ◽

pp. 3404-3407

Author(s):

Ashish W. Bele

Keyword(s):

Cerebral Palsy ◽

Sampling Procedure ◽

Muscle Stiffness ◽

Calf Muscle ◽

Central Nervous System Damage ◽

Randomized Sampling ◽

Muscle Spasticity ◽

Before And After ◽

Neurological Patients ◽

Group A

The greatest substantial consequence of juvenile impairment is cerebral palsy (CP). Spasticity of numerous muscle groupings is common after Central Nervous System damage. Spasticity causes functioning issues. For individuals suffering from CP ankle anomalies seem strongly tied to workable limits. Spastic CP is highest frequent type of CP, which limits child's responsive status and prohibits them from participating in communal activities. Soft tissue mobilisation procedures would be used in variety ways. Cryotherapy is interventional method for stiffness in neurological patients that has narrow advantage. MFR can potentially utilised against spasticity. The focus of this investigation is to evaluate Cryotherapy and MFR influence over calf muscle stiffness in participants who have Spastic Diplegic CP. The survey's goal is to determine efficacy of Cryotherapy and MFR in calf muscle spasticity in Spastic diplegic CP subjects. Thirty individuals suffering spastic diplegic CP were chosen using randomized sampling procedure. The subjects was categorised onto 3 subgroups, each of ten individuals. Cryotherapy was applied to Group A, MFR was applied to B and C Group was applied with combination of cryotherapy and MFR. Both before and after therapy, MAS and goniometry are used to assess calf muscle spasticity and ankle PROM. Overall validity of MAS and PROM comparing before and after in subgroup was determined using Tukey Test. Spasticity was reduced and range of motion was improved (p<0.05) in intra group comparison. Cumulative influence of cryotherapy and MFR is beneficial in reducing calf muscle stiffness in spastic diplegic CP children, as per this investigation.

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Efficacy of task-oriented training vs proprioceptive neuromuscular facilitation on mobility and balance in spastic cerebral palsy

Biomedicine ◽

10.51248/.v41i2.800 ◽

2021 ◽

Vol 41 (2) ◽

pp. 297-300

Author(s):

V. Rajalaxmi ◽

P Swetha ◽

R.N.V. Deepthi ◽

Raja Sathya ◽

S Omana ◽

...

Keyword(s):

Cerebral Palsy ◽

Balance Control ◽

Spastic Cerebral Palsy ◽

Timed Up And Go ◽

Significant Difference ◽

Proprioceptive Neuromuscular Facilitation ◽

Post Test ◽

Group A ◽

Group B ◽

Task Oriented

Introduction and Aim:One of the most significant and common clinical finding in a majority of children with (CP)is difficulty in walking and exhibiting poor balance control which results in poor gait and reaching movements as maintenance of stability is critical. There are numerous approaches, protocols and treatment strategies to improve balance and gait control. The aim of this study was to compare the effects of task- oriented training and proprioceptive neuromuscular facilitation exercises (PNF)on mobility and balance in spastic cerebral palsy. Methodology: This was a comparative study design with pre-post type 20 samples were selected based on the inclusion criteria and were divided into two groups. Group A received task-oriented training and group B proprioceptive neuromuscular facilitation and Pre & post measurements were done using paediatric balance scale and timed up and go test. Results:On comparing the post-test values of group A and group B both the group showed significant difference with the pre-test, on comparing the post-test values of group A and group B, group A showed better significance than group B. Conclusion: The present study concluded that there seems to be evidence that task-oriented training is more beneficial in training program for increasing the mobility and balance in spastic cerebral palsy comparing to proprioceptive neuromuscular facilitation.

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Changing Trends in Clinical Profile of Cerebral Palsy

Indian Journal of Physical Medicine and Rehabilitation ◽

10.5005/ijopmr-27-1-10 ◽

2016 ◽

Vol 27 (1) ◽

pp. 10-13

Author(s):

Vinay Goyal ◽

Nonica Laisram ◽

Tufail Muzaffar ◽

Shikha Bhatnagar

Keyword(s):

Cerebral Palsy ◽

Mental Retardation ◽

Birth Asphyxia ◽

Clinical Profile ◽

Aetiological Factor ◽

Speech Impairment ◽

Group A ◽

Care Health ◽

Group B ◽

Previous Group

Abstract Background There may be change in clinical spectrum of cerebral palsy (CP) due to improvement in maternal and child care health service. The clinical profi le, aetiological factors and comorbidities of children with CP attending Department of PMR, VMMC & Safdarjang Hospital during the years 1981- 1989 and 2008 - 2012 were therefore compared and analysis done. Methods Four hundred and ten (group B) children with CP registered in last 4 years (2008 - 2012) at PMR Department of VMMC & Safdarjang Hospital were compared with previous study of 544 (group A) children during year 1981 - 1989 from same centre. Results Spastic CP remained most common in both the groups. Diplegia is commonest type of CP (38.78%) as compared to previous group where quadriplegia (34.9%) was most common. The mixed type showed a statistical signifi cant increase in percentage (group A: 0.18 % versus group B: 3.7 %). In aetiology, there is decrease in prenatal and postnatal causes and increase in natal causes which were statistically signifi cant. Birth asphyxia (50.3 %) remains the main aetiological factor as earlier (24.5%). Speech problems (59.7%), mental retardation (31.7%) and seizures (26.8%) are common comorbidities as compared to previous studies where mental retardation (47.2 %) was found to be most common followed by speech impairment (37%), visual impairment (9%) and seizures (8.8%). Conclusions Clinical profile of CP has evolved with an increase in diplegic and a decrease in quadriplegic CP.

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Comparison between semitendinosus transfer to distal femur and medial hamstrings surgical lengthening for treatment of flexed knee gait in cerebral palsy

Journal of Orthopaedic Surgery ◽

10.1177/2309499020910978 ◽

2020 ◽

Vol 28 (1) ◽

pp. 230949902091097 ◽

Cited By ~ 1

Author(s):

Mauro César de Morais Filho ◽

Marcelo Hideki Fujino ◽

Francesco Camara Blumetti ◽

Carlos Alberto dos Santos ◽

Cátia Miyuki Kawamura ◽

...

Keyword(s):

Cerebral Palsy ◽

Knee Flexion ◽

Distal Femur ◽

Research Question ◽

Knee Extension ◽

Flexion Deformity ◽

Anterior Pelvic Tilt ◽

Group A ◽

Knee Flexion Deformity ◽

Group B

Purpose: Hamstrings surgical lengthening (HSL) has been frequently used for the treatment of flexed knee gait in cerebral palsy; however, recurrence of knee flexion deformity (KFD) and increase of anterior pelvic tilt (APT) were reported in a long-term follow-up. Research question: The aim of this study was to compare semitendinosus transfer to distal femur (STTX) and semitendinosus surgical lengthening (STL) regarding the reduction of KFD and the increase of APT after flexed knee gait treatment. Methods: One hundred and eleven patients were evaluated and they were divided into two groups according to surgical procedures at knees: group A (65 patients/130 knees), including patients who received medial HSL as part of multilevel approach; group B (46 patients/92 knees), represented by patients who underwent orthopedic surgery including an STTX instead of STL. Results: Fixed knee flexion deformity (FKFD) decreased only in group B (from 6.79° to 2.96°, p < 0.001) after intervention. In kinematics, APT increased from 16.38° to 19.03° in group A ( p = 0.003), while group B also increased from 15.26° to 20.59° ( p < 0.001). The minimum knee flexion in stance phase (MKFS) reduced from 25.34° to 21.65° ( p = 0.016) in group A and from 31° to 19.57° ( p < 0.001) in group B. In the comparison between groups A and B, the increase of APT ( p = 0.028) and reduction of FKFD ( p < 0.001), popliteal angle ( p = 0.001), bilateral popliteal angle ( p = 0.003) and MKFS ( p = 0.006) were higher after STTX than STL. Conclusion: In the present study, patients who received STTX exhibited more improvement of knee extension at clinical examination and during gait than those who underwent to STL; however, STTX was not effective to prevent the increase of APT after flexed knee gait treatment.

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Adaptive neuromodulation in the treatment of spasticity

Journal of Advanced Health Care ◽

10.36017/jahc2010-003 ◽

2020 ◽

Author(s):

Barassi Giovanni ◽

Giannuzzo Giuseppe ◽

De Santis Romano ◽

Dragonetti Antonella

Keyword(s):

Cerebral Palsy ◽

Operative Procedure ◽

Lower Limbs ◽

Rheological Parameters ◽

Therapeutic Approaches ◽

Single Session ◽

Group A ◽

Analysis Of Results ◽

Group B

This research has the purpose to evaluate the immediate effects on spasticity of lower limbs of a single session of two different therapeutic approaches in patients affected by cerebral palsy. A total of 30 patients, with an age between and 10-40 years old and affected by cerebral palsy associated to spastic para/tetra paresis, were recruited and equally and randomly divided into 3 groups: group A has was treated with hydrokinesitherapy (HKT). Group B was treated with adaptive electro neuromodulation (ENM). Group C underwent a sham approach respecting the operative procedure of Group B with the device not operating. All patients were evaluated, before (T0) and after (T1) the single session of treatment, through myometric evaluation of muscular rheological parameters. The analysis of results underlined that both HKT and ENM resulted effective in reducing muscu-lar hypertone associated to spasticity, while in Group C no significant results were detected. We can affirm that both ENM and HKT approach can be good alternatives for the treatment of spasticity in patients affected by cerebral palsy.

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Consonantal Landmarks as Predictors of Dysarthria among English-Speaking Adults with Cerebral Palsy

Brain Sciences ◽

10.3390/brainsci11121550 ◽

2021 ◽

Vol 11 (12) ◽

pp. 1550

Author(s):

Chin-Ting Liu ◽

Yuan-shan Chen

Keyword(s):

Regression Analysis ◽

Cerebral Palsy ◽

Acoustic Analysis ◽

Motor Deficits ◽

Control Group ◽

Clinical Group ◽

Group A ◽

English Speaking ◽

Dysarthric Speech ◽

And Gender

The current study explored the possibility that the consonantal landmarks served as predictors of dysarthric speech produced by English-speaking adults with cerebral palsy (CP). Additionally, the relationship between the perceptual severity of dysarthric speech and the consonantal landmarks was explored. The analyses included 210 sentences from the TORGO database produced by seven English-speaking CP speakers with dysarthria and seven typically developing controls matched in age and gender. The results indicated that the clinical group produced more total landmark features than did the control group. A binominal regression analysis revealed that the improper control of laryngeal vibration and the inability to tactically control the energy in a voiced segment would lead to the higher likelihood of dysarthric speech. A multinominal regression analysis revealed that producing too many +v and −v landmark features would lead to higher perceptual severity levels among the CP speakers. Together with literature, the current study proposed that the landmark-based acoustic analysis could quantify the differences in consonantal productions between dysarthric and non-dysarthric speech and reflect the underlying speech motor deficits of the population in concern.

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Randomized Clinical Trial to Evaluate the Efficacy of Ashtamangal Ghrita Oral and Nasya in the Management of Cerebral Palsy

International Journal of Ayurvedic Medicine ◽

10.47552/ijam.v11i3.1585 ◽

2020 ◽

Vol 11 (3) ◽

pp. 483-490

Author(s):

Shabnam Rajput ◽

Kalpana Patni

Keyword(s):

Cerebral Palsy ◽

Clinical Symptoms ◽

World Health ◽

Motor Disorder ◽

Intergroup Comparison ◽

Effect Of Therapy ◽

Group A ◽

Cdc Grading ◽

Group B ◽

Health Organization

Background: Cerebral palsy is one of the most common childhood disabilities, which hinder the development of a child, causing extensive suffering to affected children and their families. According to world health organization about 10% of population have some form of disabilities. Cerebral Palsy can be compared with Vatavyadhi(neurological disorder) manifested in various form like sarvangavata (quadri-plegia), pakshaghata (hemiparesis), ekangavata(monoplegia), pangu and khanja (motor disorder), kampavata, jadatva (mental retadation), mukatva (dumbness) etc. Objective: To evaluate the efficacy of Ashtamangal ghrita, in the form of oral medication and as nasya in the management of cerebral palsy. Material and Methods: Total 24 Children with physical and mental developmental disabilities of of age group 01 to 10 years of either sex were randomly divided into two groups, group A received Ashtamangal ghrita (orally) - 1 ml/kg body weight in two divided doses for 3 months and Group B received Pratimarsh Nasya with Ashtamangal ghrita – 2 drops in each nostril 2 times a day for 3 months. Assessments were done on the basis of 5 point grading score of Clinical symptoms of Cerebral Palsy as per standard classification scale for CP, i.e, motor functions were assessed on the basis of CDC Grading Scale for Motor milestones and Teacher’s drooling test. Follow up visit was on every 15th day. Result: Overall effect of therapy shows that there was 34.79% improvement in group A & 37.74% improvement in group B. Results were slightly superior in group B than group A in most of the parameters. Although intergroup comparison of both groups was not-significant or there were no differences in both groups statistically. Group A was slightly superior than group B in following parameters –Head holding, sitting, teacher drooling scale and spasticity. In all the other parameters group B was slightly superior. Conclusion: Clinical efficacy of both Ashtamangal ghrita orally and as nasya on various parameters of Cerebral Palsy showed that both were effective, safe and comparable.

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Educating caregivers of persons with cerebral palsy in night-time postural care: A randomized trial comparing two online training programs

Clinical Rehabilitation ◽

10.1177/02692155211009484 ◽

2021 ◽

pp. 026921552110094

Author(s):

Jennifer Ann Hutson ◽

James S Hodges ◽

LeAnn Snow

Keyword(s):

Cerebral Palsy ◽

Learning Style ◽

Interactive Video ◽

Rating Scales ◽

Training Programs ◽

Perceived Competence ◽

Night Time ◽

Double Blind ◽

Group A ◽

Double Blind Design

Objective: Compare effectiveness of two differently formatted training programs in educating night-time postural care implementers. Design: Mixed-methods parallel-group double-blind design with random assignment. Setting: United States academic institution. Participants: Thirty-eight adult caregivers/providers of children with cerebral palsy. Interventions: Both 2-hour online programs included content on night-time postural care evidence, risk-factor monitoring, sleep-system types, positioning methods, and assessments. Group A used interactive videos, Group B summary information with web-links. Main Measures: We measured self-perceived competence via questionnaires (baseline, post-training, post-simulation) containing 4-point rating-scales of knowledge, ability, and confidence and measured positioning ability via a simulation observation instrument comprising 16 positioning-task ratings with space for describing performance. We recorded participant actions/statements using fieldnotes. Results: Thirty-eight completed training (19 per group). Group A (vs B) showed significantly greater self-perceived competence changes post-training (0.46 points (SE 0.17), P = 0.008). Thirty-seven positioned a standardized “client,” with groups not differing significantly on total tasks completed correctly ( F(1, 92.32) = 1.91, P = 0.17) averaging 11.85 (SE 0.83) and 12.60 (SE 0.84) of 16 tasks correct. Group A’s post-positioning/simulation self-ratings were significantly associated with actual ability ( r = 0.53, P = 0.019). In both groups ⩾47% of caregivers incorrectly completed the tasks of placing head and neck in neutral and snugging up all [positioning] parts. Conclusion: The sleep care positioning training program (interactive video-based format) is effective in building caregivers’ self-perceived competence for night-time postural care. While the lesson was well-received by caregivers and considered a “match [to their] learning style,” the lesson did not lead to greater improvement in actual ability to position the “client” compared to control training.

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Combined Anterior-Posterior Fusion Versus Posterior Alone Fusion for Cervical Myelopathy in Athetoid-Cerebral Palsy

Global Spine Journal ◽

10.1177/2192568220987535 ◽

2021 ◽

pp. 219256822098753

Author(s):

Gang-Un Kim ◽

Myun-Whan Ahn ◽

Gun Woo Lee

Keyword(s):

Cerebral Palsy ◽

Pain Intensity ◽

Surgical Outcomes ◽

Cervical Myelopathy ◽

Neck Disability Index ◽

Posterior Fusion ◽

Japanese Orthopedic Association ◽

Group A ◽

Group B ◽

Anterior Posterior

Study Design: Retrospective comparative study. Objectives: Although some studies have discussed the use of lateral mass screws (LMSs) in patients with cerebral palsy (CP), it is unclear whether posterior LMS fixation alone is a suitable method. We aimed to compare the clinical, radiological, and surgical outcomes of 2 surgical modalities, namely, combined anterior-posterior (A-P) instrumented fusion and posterior fusion alone, in athetoid-type CP patients with cervical myelopathy (CM). Methods: We analyzed 63 patients with athetoid-CP and CM who underwent posterior fusion only with LMS (group A, 35 patients) and A-P fusion (group B, 28 patients). The primary outcome was the 1- and 3-year fusion rates for the surgical segments. The secondary outcomes included the clinical outcomes based on pain intensity determined using the visual analog scale score, neck disability index, and 17-point Japanese Orthopedic Association score, radiological, and surgical outcomes. Results: Fusion was achieved at 3 years postoperatively in 22 of 35 patients (63%) in group A and in 26 of 28 patients (93%) in group B ( P = 0.02). The posterior neck pain intensity was also significantly lower in group B than in group A 2 and 3 years postoperatively ( P = 0.02 and 0.01, respectively). The incidence of screw loosening and implant-related problems was higher in group A (60%) than in group B (21%) ( P = 0.01). The other clinical and radiological parameters were similar between the groups. Conclusions: For athetoid CP-induced CM, combined A-P fusion would result in superior clinical and radiological outcomes compared to posterior fusion alone.

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